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Predictors of Clinical Outcome After Treatment of Intracranial Aneurysms with the Pipeline Embolization Device.

Publication ,  Journal Article
Griffin, A; Reese, V; Hüseyinoglu, Z; Niedzwiecki, D; Yang, L; Cutler, A; Gonzalez, LF; Zomorodi, A; Smith, T; Hauck, EF
Published in: World Neurosurg
October 2019

BACKGROUND: Flow-diverting stents have revolutionized the endovascular treatment of intracranial aneurysms. The purpose of this study is to identify predictors of adverse outcomes associated with the pipeline embolization device (PED). METHODS: A retrospective analysis of all patients treated with PED at a single high-volume center from January 2014 to September 2018. Patient outcomes, neurologic morbidity/mortality, and other clinical variables were analyzed. RESULTS: We treated 204 aneurysms in 170 patients with PED. Mean length of follow-up was 11 months. Most (181) aneurysms (89%) were located in the anterior circulation, and 23 (11%) were found in the posterior circulation. Most aneurysms were saccular (82%), followed by fusiform (11%), blister (4%), and dissecting pseudoaneurysms (3%). Mean aneurysm size was 8.2 + 5.7 mm with 145 (71%) small aneurysms (≤10 mm), 53 (26%) large aneurysms (between 10 and 25 mm), and 6 (3%) giant aneurysms (≥25 mm). Ninety-two percent of aneurysms were unruptured, and 8% were ruptured. The overall major neurologic morbidity/mortality was 4.7% and 1.8%, respectively. The all-cause mortality was 2.9%. Predictors of neurologic morbidity/mortality included the baseline modified Rankin Scale (P = 0.001), aneurysm neck size (P = 0.003), aneurysm size (P = 0.006), anterior versus posterior location (P = 0.02), and rupture at presentation (0.006). The P2Y12 Reactivity Unit, parent vessel diameter, and patient age did not correlate with adverse events. CONCLUSIONS: The PED has a satisfactory safety profile in both on- and off-label indications. A poor clinical patient baseline, wider aneurysm neck or larger size, and rupture predict an increased risk of an unfavorable outcome.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

October 2019

Volume

130

Start / End Page

e666 / e671

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Self Expandable Metallic Stents
  • Retrospective Studies
  • Predictive Value of Tests
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans
  • Follow-Up Studies
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Griffin, A., Reese, V., Hüseyinoglu, Z., Niedzwiecki, D., Yang, L., Cutler, A., … Hauck, E. F. (2019). Predictors of Clinical Outcome After Treatment of Intracranial Aneurysms with the Pipeline Embolization Device. World Neurosurg, 130, e666–e671. https://doi.org/10.1016/j.wneu.2019.06.185
Griffin, Andrew, Vanessa Reese, Zeynep Hüseyinoglu, Donna Niedzwiecki, Lexie Yang, Andrew Cutler, L Fernando Gonzalez, Ali Zomorodi, Tony Smith, and Erik F. Hauck. “Predictors of Clinical Outcome After Treatment of Intracranial Aneurysms with the Pipeline Embolization Device.World Neurosurg 130 (October 2019): e666–71. https://doi.org/10.1016/j.wneu.2019.06.185.
Griffin A, Reese V, Hüseyinoglu Z, Niedzwiecki D, Yang L, Cutler A, et al. Predictors of Clinical Outcome After Treatment of Intracranial Aneurysms with the Pipeline Embolization Device. World Neurosurg. 2019 Oct;130:e666–71.
Griffin, Andrew, et al. “Predictors of Clinical Outcome After Treatment of Intracranial Aneurysms with the Pipeline Embolization Device.World Neurosurg, vol. 130, Oct. 2019, pp. e666–71. Pubmed, doi:10.1016/j.wneu.2019.06.185.
Griffin A, Reese V, Hüseyinoglu Z, Niedzwiecki D, Yang L, Cutler A, Gonzalez LF, Zomorodi A, Smith T, Hauck EF. Predictors of Clinical Outcome After Treatment of Intracranial Aneurysms with the Pipeline Embolization Device. World Neurosurg. 2019 Oct;130:e666–e671.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

October 2019

Volume

130

Start / End Page

e666 / e671

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Self Expandable Metallic Stents
  • Retrospective Studies
  • Predictive Value of Tests
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Humans
  • Follow-Up Studies
  • Female